Committee Activity Request Committee Name*AnesthesiologyCardiologyCritical CareDermatologyDiagnostic RadiologyEmergency MedicineFamily MedicineGastroenterologyGeneral SurgeryGeriatric MedicineImmunology and Infectious DiseaseInternal MedicineInterventional RadiologyNeurological SurgeryNeurologyObstetrics and GynecologyOncologyOphthalmologyOrthopaedic SurgeryOtolaryngologyPain MedicinePathologyPediatricsPhysical Medicine and RehabilitationPlastic SurgeryPsychiatryRadiation OncologySports MedicineThoracic, Cardiac, and Vascular SurgeryUltrasoundUrologyWilderness MedicineArtificial Intelligence in MedicineArts in MedicineBusiness and Innovation in MedicineGlobal Surgery and MedicineMedical EducationMind-Body MedicineNutritionHealth Policy and AdvocacyMedical EthicsPlanetary and Environmental HealthMedical School for Kids OutreachYour Name* First Last UFL Email* Enter Email Confirm Email Co-Chair Name First Last Co-Chair UFL Email Enter Email Confirm Email Event Title*This is how your event will appear on the MCC calendar.Event Type*You may check multiple boxes if more than one applies. General Meeting Workshop/Seminar Special Event/Series Is the event more than 14 days away?*Requests submitted in advance will be prioritized. Your request may be denied if your event is less than 14 days away. Yes No Date of Event* MM slash DD slash YYYY Event Time*Include start and end time of event. Only 2 committees at a time are permitted to host events during the noon lunch hour. Requests will be rejected if 2 have already been approved for the date selected. Hosting Format*Indicate how students will be able to attend the event. In person Hybrid Zoom Will the Event Be Held In HMEB or other COM location?* Yes No Location*Room request link: https://ufl.emscloudservice.com/web/Default.aspxZoom link*Speaker info*You may check multiple boxes if more than one applies. UF faculty Not UF-affiliated UF alumni No Speaker Speaker Information*Name & AffiliationSpeaker Information*Name & DepartmentAttendance Capacity Restrictions?*Is there a limit/restriction on how many students can attend this event? Yes No Attendance Capacity*State how many students max are allowed at this event.Please enter a number greater than or equal to 1.Will this meeting require attendees to RSVP?* Yes No RSVP link:*Brief Event Description*How will this meeting benefit the UFCOM community?*Terms*By completing this request, you agree to submit the MCC Activity Follow Up Form if approved. Failure to do so, may prevent your Committee from hosting events for the remainder of the academic year. Agree Untitled First Choice Second Choice Third Choice